Objectives: To summarize the experiences of CT-guided microcoil localization before video-assisted thoracoscopic surgery (VATS) and to investigate the risk factors associated with pleural marking failure.
Methods: Totally, 249 consecutive patients with 279 pulmonary nodules who underwent CT-guided microcoil localization prior to VATS were enrolled in this study. According to intraoperative observation, all the nodules were divided into two groups. The clinical characteristics and microcoil localization procedure-related variables of the nodules were analyzed by univariate analysis and multivariate logistic regression analysis to screen the independent factors associated with procedure results.
Results: Among the 279 nodules, 28 failed to observe the proximal end of the microcoil deployed on visceral pleura during VATS. The logistic regression revealed that needle-pleura angle (≤ 30°: OR = 39.022, p = 0.003), pleura-microcoil distance (≤ 10 mm: OR = 87.054, p < 0.001; 10~20 mm: OR = 10.088, p = 0.010), and presence of pleural indentation (OR = 21.623, p < 0.001) were independent risk factors for pleural marking failure.
Conclusions: CT-guided microcoil localization for pulmonary nodules is a safe and effective procedure. Small needle-pleura angle (≤ 30°), pleura-microcoil distance (≤ 20 mm), and the presence of pleural indentation during the procedure are significant risk factors contributing to microcoil pleura marking failure.
Key Points: • CT-guided microcoil localization for pulmonary nodules was a safe and effective procedure. • CT-guided microcoil localization for pulmonary nodules yielded low complication rates. • Small needle-pleura angle, short pleura-microcoil distance, and the presence of pleural indentation were contributing to pleura marking failure.
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